Image Release Form CSUCI_Staff-Students
Visual/Audio Image Release Form
I grant permission to California State University, its employees and agents, to take and use
visual/audio images of me. Visual/audio images are any type of recording, including but not
limited to photographs, digital images, drawings, renderings, voices, sounds, video recordings,
audio clips or accompanying written descriptions. CSU will not materially alter the original
images. I agree that CSU owns the images and all rights related to them. The images may be
used in any manner or media without notifying me, such as university-sponsored web sites,
publications, promotions, broadcasts, advertisements, posters and theater slides, as well as for
non-university uses. I waive any right to inspect or approve the finished images or any printed or
electronic matter that may be used with them, or to be compensated for them.
I release CSU and its employees and agents, including any firm authorized to publish and/or
distribute a finished product containing the images, from any claims, damages or liability which I
may ever have in connection with the taking of use of the images or printed material used with
the images.
I am at least 18 years of age and competent to sign this release. I have read this release before
signing, I understand its contents, meaning and impact, and I freely accept these terms.
__________________________ ___________________________________
Printed Name Date
__________________________ ___________________________________
Signature Telephone
___________________________ ___________________________________
Parent or Guardian if under Email Address
18 years of age
Channel Islands
CSU Campus
OFFICE USE ONLY:
Project or Event Name:
Photographer name/signature/contact information/notes:
